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The Elusiveness of Hermeneutical Injustice in Psychiatric Categorizations

This blogpost is by Miriam Solomon on her recently published paper, 'The Elusiveness of Hermeneutical Injustice in Psychiatric Categorizations' (Social Epistemology, 2024).


Miriam Solomon

Miranda Fricker’s (2007) concept of “hermeneutical injustice” is a helpful critical tool for thinking about how improved social identities become available to those who can benefit from them. Fricker argues that dominant conceptual frameworks are often inadequate and unjust in that, for reasons of social prejudice, they get in the way of understanding important aspects of one’s own social experience. For example, during the 1950s, dominant stereotypes about male homosexuals—stereotypes that were both negative and inaccurate—prevented men who preferred sex with men from understanding their societal roles. 

Fricker writes about the “Aha!” moment when a more accurate and positive social identity becomes available, correcting the hermeneutic injustice. Her examples include 1960s gay male identity (replacing negative stereotypes of the male homosexual with something more accurate and positive), the experience named post-partum depression (replacing judgments of incompetence at motherhood, or “craziness”), and the experience of sexual harassment (replacing judgments of women’s excessive sensitivity or prudishness).

In the early 1990s, the psychiatrist Lorna Wing successfully advocated for a new diagnostic category within the broad family of autistic disorders. She called it Asperger Syndrome and used it to describe less profoundly affected individuals on the autism spectrum, typically individuals with verbal and other intellectual abilities. The diagnosis was welcomed, at first by parents and then by diagnosed individuals, as a diagnostic/social category that was both more acceptable and more descriptive than autism. 

When Asperger Syndrome was removed (for scientific reasons) from the Diagnostic and Statistical Manual of Psychiatric Disorders in the fifth edition (2013), and absorbed into a more widely encompassing autism spectrum, there was some push back from those who had embraced the Asperger diagnosis in themselves or their family members and felt that they had lost an important social identity.

My recent article “The Elusiveness of Hermeneutical Injustice in Psychiatric Categorizations”(Solomon, 2024) looks at the case of Asperger Disorder, and several other psychiatric categorizations, to argue that Fricker’s underlying assumption that “hermeneutical enlightenment” is accompanied by both increased accuracy and increased social justice does not hold for the typical case in psychiatric categorization. 

In the case of Asperger Syndrome, the more positive social identities of those with the Asperger diagnosis were obtained at the expense of reinforcing the more negative social identities of those with an autism diagnosis, a process that Hilde Lindemann (Nelson, 2001) has called “hostage taking.” The overall cause of justice is not served. Moreover, although some have the experience of “hermeneutical enlightenment” (an “Aha!” moment), this may reflect the emotional appeal of the identity rather than serve as a marker of increased scientific accuracy.

In looking at several additional cases (postpartum depression, Tourette’s syndrome, psychosis risk syndrome, and the concept of psychiatric disorder in general) I found many “hermeneutic hotspots”: areas in which social identities are contested, and in which it is difficult to discern the overall contributions to hermeneutical justice that a proposed change involves. 

It is also difficult to discern the reasons why a particular social category resonates or is resisted. Social identities have a good deal of complexity, ambiguity, uncertainty and inscrutability. Even if these challenges are met, it is demanding to come to an overall assessment of whether the interests of justice are served and how hermeneutical justice should be balanced with other important goals of psychiatric classification. The ideal of hermeneutical justice is elusive.

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